Individual
SUSAN M THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, APN
Contact information
Practice address
2475 MCCLELLAN AVE BLDG C, PENNSAUKEN, NJ 08109-4683
(856) 675-3355
Mailing address
2475 MCCLELLAN AVE BLDG C, PENNSAUKEN, NJ 08109-4683
(856) 675-3355
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
NO11378200
NJ
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00033500
NJ
363LG0600X
Gerontology Nurse Practitioner
NJ00033500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0023892
—
NJ
Enumeration date
01/23/2006
Last updated
12/13/2021
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